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Advanced CHAIN OF CUSTODY RECORD <br /> Date -13r-3 Page l ofd_ <br /> GeoEnvironmental, Inc. <br /> 837 Slaw Road- Stockton, California- 88215-(209) 467-1006- Fax (209) 467-1118 <br /> Client Project Manager , Tests Required <br /> Phone Number <br /> WL <br /> Samples (Signature) invoice <br /> Protect Name <br /> 46��A <br /> AGE� Client ❑ <br /> Sample Location Sample Type No of <br /> Number Description Date Time Water Air Solid Conts Notes <br /> Comp arab <br /> i <br /> rEf N 4- -13 3 3© se X XIx I A I <br /> 5 ►/ <br /> oaaTrAIA OYU <br /> QOOD±C0 APMPAIAT& <br /> FtfSAUENT %11AINTsRB <br /> + <br /> !ee/llUfgui e y r tureReceived y T§Tg—n-at-u-re-F <br /> Daterrime <br /> v" '' � Oate <br /> Relinquished by (Signature) Received try (Signature) rT+me <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DalelTime <br /> Dispatched by (Signature) Date/Time Received for Laboratory byr^- D ta/Trme <br /> Iq b <br /> Method of Shipment Laborsto me <br /> etC- GIL e� <br /> Special Instructions ` f* - L I hereby authorize thil performance of the above Indicated work <br /> I <br />